Self-regulation and assessment approaches for vaso-occlusive pain management for pediatric sickle cell anemia patients

An interdisciplinary program with the goal of teaching self-regulation and minimizing excessive narcotic use in the management of vaso-occlusive pain (V-O) in pediatric sickle cell anemia patients is described. A small group of patients do not respond well to any of our outpatients or inpatients med...

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Bibliographic Details
Published inInternational journal of psychosomatics : official publication of the International Psychosomatics Institute Vol. 39; no. 1-4; p. 28
Main Authors Hall, H, Chiarucci, K, Berman, B
Format Journal Article
LanguageEnglish
Published United States 1992
Subjects
Adaptation, Psychological
Anemia, Sickle Cell - physiopathology
Anemia, Sickle Cell - psychology
Arousal - physiology
Biofeedback, Psychology - physiology
Child
Female
Humans
Hypnosis
Imagination
Pain Measurement
Psychophysiology
Relaxation Therapy
Sick Role
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Summary:An interdisciplinary program with the goal of teaching self-regulation and minimizing excessive narcotic use in the management of vaso-occlusive pain (V-O) in pediatric sickle cell anemia patients is described. A small group of patients do not respond well to any of our outpatients or inpatients medical regimens, leading us to suspect that psychological factors are influencing pain reports. We outline our multi-faceted assessment approach to evaluating such psychological factors, which includes a pain flow sheet, symptom check list, and a psychophysiologic profile. Published reports of self-regulation training including biofeedback, relaxation/imagery, and hypnosis have been associated with decreased pain symptoms, reduced number of emergency room and hospital visits for pain, decreased narcotic use, and increased school attendance. A case study of a nine-year-old patient with sickle cell disease is described before and after self-regulation training. Finally, other alternative approaches that avoid excessive narcotic use are discussed with some case reports.
ISSN:0884-8297